Cognitive Behavioral Therapy Changes the Brain's Wiring

Cognitive
behavior therapy (CBT) - a specific type of talking therapy - involves people changing
the way they think about and respond to their thoughts and experiences.

Cognitive Behavioral Therapy Changes the Brain's Wiring

For individuals experiencing psychotic symptoms, common in schizophrenia
and a number of other psychiatric disorders, the therapy involves
learning to think differently about unusual experiences, such as
distressing beliefs that others are out to get them. CBT also involves
developing strategies to reduce distress and improve wellbeing.

‘Cognitive behavior therapy strengthens connections in the brains of people with psychosis, and that these stronger connections are associated with long-term reduction in symptoms and recovery eight years later.’

A new study from King's College London and South London and Maudsley
NHS Foundation Trust has shown for the first time that cognitive
behavior therapy strengthens specific connections in the brains
of people with psychosis, and that these stronger connections are
associated with long-term reduction in symptoms and recovery eight years
later.

The findings, published in the journal Translational Psychiatry,
follow the same researchers' previous work which showed that people
with psychosis who received CBT displayed strengthened connections
between key regions of the brain involved in processing social threat
accurately.

The new results show for the first time that these changes continue
to have an impact years later on people's long-term recovery.

In the original study, participants underwent fMRI imaging to assess
the brain's response to images of faces expressing different emotions,
before and after six months of CBT. Participants were already taking
medication when they took part in the study, and so were compared to a
group receiving medication only. The group receiving medication only did
not show any increases in connectivity, suggesting that the effects on
brain connections could be attributed to the CBT.

For the new study, the health of 15 of the 22 participants who
received CBT was tracked for eight years through their medical records.
They were also sent a questionnaire at the end of this period to assess
their level of recovery and wellbeing.

The results show that increases in connectivity between several
brain regions - most importantly the amygdala (the brain's threat
centre) and the frontal lobes (which are involved in thinking and
reasoning) - are associated with long-term recovery from psychosis.
This is the first time that changes in the brain associated with CBT
have been shown to be associated with long-term recovery in people with
psychosis.

Lead author of the study Dr Liam Mason from King's College London,
who is a clinical psychologist at the Maudsley Hospital where the
research took place, said: "This research challenges the notion that the
existence of physical brain differences in mental health disorders
somehow makes psychological factors or treatments less important.
Unfortunately, previous research has shown that this 'brain bias' can
make clinicians more likely to recommend medication but not
psychological therapies. This is especially important in psychosis,
where only one in ten people who could benefit from psychological
therapies are offered them."

The researchers now hope to confirm the results in a larger sample,
and to identify the changes in the brain that differentiate people who
experience improvements with CBT from those who do not. Ultimately, the
results could lead to better, and more tailored, treatments for
psychosis, by allowing researchers to understand what determines whether
psychological therapies are effective.

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